Improving Wrist Strength Assessment Reliability: A Review of Handheld Dynamometry Protocols and Their Clinical...

Background: Handheld dynamometry (HHD) is widely utilized for assessing muscle strength, particularly in the wrist. However, variability in measurement reliability due to differences in testing protocols poses a challenge for clinical and research applications. Methods: The design of this study includes a scoping review of the literature, conducted following the PRISMA-ScR checklist methodology developed by the Joanna Briggs Institute. The databases most commonly cited in review articles were consulted: EBSCO, PEDro, PubMed, Scopus, and Cochrane Library. The following MeSH terms were used: "Handheld Dynamometer", "Wrist", "Forearm", "Muscle", and "Strength". The search strings were built using combinations of these terms. Article screening was performed by three reviewers independently, blinded to each other's selections. Results: The review indicates that HHD can provide reliable measurements when standardized protocols are used. Most studies reported high intra-examiner reliability with Intraclass Correlation Coefficients (ICCs) between 0.71 and 0.90. However, inter-examiner reliability showed more variability, particularly when more than two examiners were involved. The review also highlights the importance of precise dynamometer placement and consistent patient positioning in order to reduce measurement variability. Conclusions: While HHD is a valuable tool for wrist strength assessment, the effectiveness of its measurements largely depends on the testing procedure's standardization. Implementing validated standardized protocols is essential in enhancing measurement reliability and ensuring their consistent application across clinical settings. Further research is needed to firmly implement these protocols and expand their application in clinical practice.